Peptic Ulcer Disease and Its Association with Metabolic Syndrome among Medical-checkup Subjects from One Teaching Hospital in Taiwan
 
Jung-Yu Shen1, Mei-Fong Wu2, Yu-Jun Chang3, Pei-Yu Yang4and I-Ching Lin1,5,6

 Purpose:Previous studies have indicated that a high body mass index is a risk factor for asymptomatic peptic ulcer disease. A high body mass index is also the main risk factor for metabolic syndrome. This study aimed to evaluate the association between peptic ulcer disease and metabolic syndrome.
Methods:This was a cross-sectional study conducted at one teaching hospital in midland of Taiwan, from January 2013 to December 2014. We reviewed the medical-checkup result of participants who visited the Health Examination Center of the hospital. We included 4,895 participants who received upper gastrointestinal endoscopy.
Results:The mean age of the 4,895 participants was 50.01 ± 11.2 years. In simple logistic regression analysis, peptic ulcer disease was related to age (odds ratio [OR] 1.99, 95% CI 1.60-2.48), male sex (OR 1.76, 95% CI 1.50-2.07), increased abdominal circumference (OR 1.43, 95% CI 1.22-1.67), increased triglycerides (OR 1.21, 95% CI 1.03-1.43), elevated blood pressure (BP) (OR 1.80, 95% CI 1.54-2.09), elevated fasting blood glucose (OR 1.45, 95% CI 1.24-1.69) and metabolic syndrome (OR 1.56, 95% CI 1.33-1.82). In multiple regression analysis, peptic ulcer disease was related to male sex (OR 1.51, 95% CI 1.27-1.79), smoking (OR 1.46, 95% CI 1.19-1.78), increased abdominal circumference (OR 1.22, 95% CI 1.03-1.44) and elevated BP (OR 1.46, 95% CI 1.24-1.73). After adjusting for age, sex and smoking, peptic ulcer disease was still associated with metabolic syndrome (OR 1.39, 95% CI 1.19-1.64).
Conclusion: Metabolic syndrome is associated with peptic ulcer disease. Lifestyle modifications and treating metabolic syndrome may prevent peptic ulcer disease.
(Taiwan J Fam Med 2019; 29: 23-33) DOI: 10.3966/168232812019032901003
 
Key words:metabolic syndrome, obesity, peptic ulcer disease

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¹Department of Family Medicine, 2Health Examination and 3Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua; 4Department of Laboratory, Show Chwan Memorial Hospital, Changhua; 5School of Medicine, Kaohsiung Medical University, Kaohsiung; 6School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Received: November 12, 2018; Revised: December 13, 2018; Accepted: December 25, 2018.

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台灣某教學醫院健檢受檢者之代謝症候群與消化性潰瘍之相關性
 
沈容宇¹　吳美鳳²　張玉君³　楊佩玉⁴　林益卿^1,5,6

目的：在亞洲（包括台灣），消化性潰瘍的盛行率有越來越多的趨勢。過去的研究顯示高身體質量指數是無症狀消化性潰瘍的危險因子之一。且高身體質量指數是代謝症候群的主要危險因子。然而很少研究討論消化性潰瘍和代謝症候群的相關性。本篇研究是評估消化性潰瘍和代謝症候群之間的相關性。
方法：這篇是從2013年至2014年的橫斷式研究，總共4,895位受試者，匯集其基本資料（年齡、身高、體重、身體質量指數、腹圍、病史及生活習慣），並在台灣中部一所教學醫院的健檢中心接受身體理學檢查、抽血檢驗和胃鏡檢查。代謝症候群的定義是根據台灣衛生署國民健康局的診斷標準。
結果：4,895位受試者，平均年齡為50.01±11.2歲，消化性潰瘍和代謝症候群的盛行率分別為16.8%和28.5%。在簡單邏輯斯迴歸分析(simple logistic regression model)，消化性潰瘍和年齡(odds ratio [OR] 1.99, 95% CI 1.60-2.48)，男性(OR 1.76, 95% CI 1.50-2.07)，腹部肥胖(OR 1.43, 95% CI 1.22-1.67)，高三酸甘油酯(OR 1.21, 95% CI 1.03-1.43)，高血壓(OR 1.80,95% CI 1.54-2.09)，高飯前血糖(OR 1.45, 95% CI 1.24-1.69)相關。代謝症候群和消化性潰瘍有相關性(OR 1.56, 95% CI 1.33-1.82)。在多元迴歸分析(multiple regression model)，消化性潰瘍和男性(OR 1.51, 95% CI 1.27-1.79)，腹部肥胖(OR 1.22, 95% CI 1.03-1.44)，高血壓(OR1.46, 95% CI 1.24-1.73)相關。如控制年齡性別與吸菸，消化性潰瘍和代謝症候群有顯著相關(OR 1.39, 95% CI 1.19-1.64)。
結論：這個研究顯示代謝症候群和消化性潰瘍具有相關性。年齡、男性、腹部肥胖、高三酸甘油酯、高血壓、高飯前血糖都與消化性潰瘍相關。因此，對有代謝症候群的族群可加強生活型態的改善，以期避免消化性潰瘍的發生。
（台灣家醫誌2019; 29: 23-33）DOI: 10.3966/168232812019032901003
 
關鍵詞：消化性潰瘍、肥胖、代謝症候群

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¹彰化基督教醫院家庭醫學科、²健康檢查科、³流行病學與統計中心；⁴秀傳紀念醫院檢驗科、5高雄醫學大學醫學院、6中山醫學大學醫學院
受理日期：107年11月12日　　修改日期：107年12月13日　　接受刊登：107年12月25日